New treatment for vulvar cancer soon

New treatment just as effective, fewer side effects

For some patients with cancer of the vulva or labia, new radiotherapy is a good alternative to the current treatment, in which all lymph nodes are removed.

The new treatment has far fewer side effects than the current treatment. This is evident from a study conducted by an international consortium led by UMCG.

Current treatment with many side effects
In patients with cancer of the vulva or labia, the standard treatment is to remove the tumor. For tumors less than four centimeters in size, the so-called sentinel node procedure is performed: an operation in which not all lymph nodes are removed, but only the stations of the first lymph nodes from the groin or groin. When the sentinel node contains metastasis, all lymph nodes from the groin or groin are removed during a second operation. This procedure is associated with many short- and long-term side effects, such as problems with wound healing, inflammation and the development of lymphedema in the legs.

rare case
In 2005, Ati van der Zee, Chairman of the Board of Directors of UMCG, began a study to see if radiotherapy for patients with sentinel node metastasis would be a good alternative to surgery in which all lymph nodes are removed. From the start of the study until 2016, the study included a total of 1,535 patients from 59 hospitals from 11 different countries. Because vulvar cancer is a rare condition, this international effort over such a long period has been necessary to access sufficient data.

New treatment just as effective, fewer side effects
Research now shows that for patients with metastases smaller than 2 mm, radiotherapy is a good alternative to surgery in which all lymph nodes are removed. Patients who have undergone this treatment have fewer side effects of the treatment, while the results of the treatment equal the results of the current treatment.

For patients with sentinel node metastasis greater than 2 mm in size, radiation alone was insufficient. UMCG is starting a follow-up study of these patients, to see if radiation therapy with chemotherapy offers a solution.

“This is great news for patients,” says UMCG researcher Maaike Oonk, who led the study with Ate van der Zee. With current treatment, the risk of side effects is very high. This new treatment is a huge step forward. We expect this to become the new standard soon, and now that’s the next step.

The results of the study were published in Journal of Clinical Oncology